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Health minister Eric Hoskins drew heat from fellow doctors and political peers on Wednesday over Ontario’s stem cell transplant crisis, which has seen under-funded hospital programs rationing life-saving treatment as patients are dying on unacceptably long wait lists.

A Toronto Star investigation this week revealed more than 200 of Ontario’s sickest patients, who are ready for a transplant and have been matched with a donor, cannot be helped at home. Instead, the ministry has decided to outsource this critical care to hospitals in Buffalo, Cleveland and Detroit at a cost that could exceed $100 million. Cancer Care Ontario told the Star the ministry expects to pay $400,000 to $600,000 (US) per patient — more than double the rate in Ontario.

The money is ready to go but the patients are not. Only 19 have agreed to go south so far. The treatment requires patients to travel with a caregiver and live in the U.S. near the hospital for three to four months. These personal costs are not covered by the government program.

“The situation highlights the continued mismanagement of health care by this government,” Conservative health critic Jeff Yurek said during Question Period. “The situation did not come about without warning. In 2008, Cancer Care Ontario released a report to this government. It stated: ‘Access to transplant services in Ontario is at imminent risk . . . Services in the Greater Toronto Area need to be augmented as there is only one program to serve the entire region.’ The government ignored that warning. Now the system is broken and Ontarians are suffering.”

Princess Margaret, the country’s leading cancer centre, closed its doors to new stem cell transplant patients at the end of March. The centre’s waiting list for treatment is six to eight months; international standards dictate that transplantation occur within three months of diagnosis.

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Princess Margaret’s medical director is calling for a second transplant centre to open in the GTA.

“I’ve never heard of a city in North America the size of Toronto that doesn’t have at least two transplant centres,” Dr. Irwin Walker, medical director of the bone marrow transplant program in Hamilton, said in an interview.

Hoskins said in Question Period that Cancer Care Ontario is working with Juravinski Hospital in Hamilton, The Ottawa Hospital and Princess Margaret Cancer Centre to rebuild their programs. The process is expected to take two to three years.

“Patients now have two choices: die, or travel out of country for their treatments,” Yurek said. “Will the minister stop the political rhetoric and give an honest answer to Ontarians on how the government will help those seeking stem cell transplants in Ontario today, instead of two years from now?”

Hoskins noted the three Ontario programs responsible for stem cell transplants using unrelated donors — the most complicated and expensive kind of transplant, which is growing in popularity as people have fewer siblings to rely on — will receive a collective $30 million.

“We’re working with them on the capital, we’re working with them on the operational (pressures), but we’re also providing that option for individuals for out-of-country treatments, should they so choose it,” Hoskins said.

Yurek tried again.

“Will the minister admit that they failed Ontarians, ignored the warnings of imminent collapse of the system, and offer immediate relief to patients needing life-saving stem cell transplants?”

Hoskins said his government has increased funding for stem cell transplants in the past four years by “600 per cent.”

“I know Opposition doesn’t want to hear the truth, but I’m telling them that they’ve increased the number of transplants taking place at Princess Margaret hospital by 25 per cent,” Hoskins said.

“600 per cent.......!!!! I can’t take that seriously,” Walker, Juravinski’s stem cell transplant director, told the Star in an email.

“We’ve grown 25 per cent without really getting any new capacity,” Princess Margaret’s Gospodarowicz explained. “We need to have more doctors, more nurses. We have challenges with our laboratories, pharmacy, pathology. There’s a lot of infrastructure.”

At Roswell Park Cancer Centre in Buffalo, where Ontarians are being treated, a team of 60 health-care workers — including doctors, nurses, laboratory and pharmacy staff — interact directly with stem cell patients. The scope of the treatment demands a large, cooperative team.

Directors province-wide agree that staff are working harder than ever and are on the edge of burnout. But it’s not because a geyser of money is rushing into their programs.

The Ottawa Hospital is doing 50 per cent more transplants than 18 months ago and all resources are lagging, said Dr. Chris Bredeson, the hospital’s head of malignant hematology.

“There are not 50 per cent more people doing 50 per cent more transplants,” Bredeson said. “Every day is a juggling match. How are we going to get 22 patients in the same number of beds that we used to put 12? And how do you do that without making a mistake?

“We feel sick. It keeps me, it keeps all of us, awake. No solution will be fast enough.”

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